scholarly journals Subclinical thiamine deficiency identified by pretreatment evaluation in an esophageal cancer patient

2020 ◽  
Author(s):  
Akira Yoshioka ◽  
Izumi Sato ◽  
Hideki Onishi ◽  
Mayumi Ishida
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Treatment Plan ◽  
The Body ◽  
Nutritional Evaluation ◽  
Ocular Symptoms ◽  
Marked Decline ◽  
Thiamine Level

Abstract Despite the fact that both thiamine deficiency (TD) and Wernicke encephalopathy (WE) have been observed to some degree in cancer patients, such cases of TD and/or WE reported to date have all been diagnosed after the initiation of treatment. We here report a case of TD that presented without the commonly accepted triad of WE symptoms based on a total nutritional evaluation prior to the onset of treatment for cancer. The patient was a 71-year-old man with esophageal cancer who was referred to the oncology outpatient clinic for evaluation to determine the treatment plan. Although he did not present with delirium, cerebellar signs, or ocular symptoms, TD was suspected based on a reduction in appetite lasting 2 months as thiamine stores in the body are depleted in as few as 18 days. Blood findings showed a marked decline in serum thiamine level supported, which the diagnosis of TD. This case revealed the existence of a cancer patient with subclinical TD prior to the onset of treatment for cancer. Due to the fact that TD can occur without the characteristic symptoms as in this case, we believe it is important that total nutritional evaluation of cancer patients always be considered.

PS02.249: VARIATION IN BODY COMPOSITION IN ESOPHAGEAL CANCER PATIENTS RECEIVING SUPPLEMENTARY JEJUNOSTOMY FEEDING DURING NEOADJUVANT CHEMORADIOTHERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 194-194
Author(s):  
Piers R Boshier ◽  
M F J Seesing ◽  
Vickie E Baracos ◽  
Donald E Low
Keyword(s):  
Esophageal Cancer ◽  
Body Composition ◽  
Cancer Patients ◽  
Neoadjuvant Chemoradiotherapy ◽  
The Body ◽  
Tissue Loss ◽  
Tube Placement ◽  
Average Weight ◽  
Term Survival ◽  
Jejunostomy Feeding

Abstract Background Cancer of the esophagus has one of the highest known associations with cancer–related malnutrition. The aim of the current study was to investigate variation in the body composition of esophageal cancer patients receiving supplementary jejunostomy feeding during neoadjuvant chemoradiotherapy (nCRT) and to assess its correlation with outcomes. Methods Retrospective review of esophageal cancer patient's receiving jejunal feeding during nCRT. Patients selected for jejunal feeding tube placement were considered at high nutritional risk according to ASPEN criteria. Assessment of body composition was performed using L3-axial CT images acquired at diagnosis and after nCRT. Results Eighty-one patients were eligible for inclusion (67 M, 65.9 ± 9.7 yrs). Average weight loss and BMI at diagnosis was 11.4 ± 6.5 Kg and 26.1 ± 4.6 Kg/m2 respectively. Failure to complete nCRT as prescribed occurred in one patient. Following nCRT the prevalence of sarcopenia increased significantly in males despite jejunal feeding (69% vs. 87%; P = 0.013) but fell in females (57% vs. 50%; P = 0.705). Patients could be categorized into three distinct groups according to the degree of skeletal muscle loss (ΔSMM) during nCRT: minor-loss/no-change (n = 28; Δ > −6 cm2); moderate loss (n = 27; Δ−17 to −6 cm2), and; severe loss (n = 26; Δ<17 cm2). A female predominance was observed amongst patients with minor-loss/no-change in SMM compared to patients with moderate and severe losses during nCRT (36% vs. 11% vs. 4%; P = 0.005). Visceral obesity was also less common in patients with minor-loss/no-change in SMM compared to patients with moderate and severe losses during nCRT (39% vs. 48% vs. 58%; P = 0.401). Compared to patients with moderate and severe SMM losses patients in whom SMM was persevered by jejunal feeding during nCRT tended to have lower rates of over-all complications (62% vs. 59% vs. 43%; P = 0.318); pneumonia (27% vs. 11% vs. 11%; P = 0.186), and; pulmonary embolism (15% vs. 0% vs. 0%; P = 0.012). Long-term survival was not affected by either sarcopenia or SMM and adipose tissue loss during nCRT (P > 0.05). Conclusion This is the first study to report variation in body composition in esophageal cancer patients receiving a defined nutritional intervention during nCRT. In selected patients jejunal feeding appeared to stabilize parameters of body composition whilst other patients experienced significant losses. Observed changes in body composition predominantly reflect sex differences and may offer an opportunity to improve nutritional monitoring and future patient care. Disclosure All authors have declared no conflicts of interest.

scholarly journals Prognostic and clinicopathological importance of microRNA-140 expression in cancer patients: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mengxia Zheng ◽  
Jingting Liu ◽  
Chunyan Meng ◽  
Kaifeng Tang ◽  
Jianhua Liao
Keyword(s):  
Cancer Patient ◽  
Cancer Patients ◽  
English Literature ◽  
Meta Analysis ◽  
Positive Lymph Node ◽  
The Body ◽  
Cancer Prognosis ◽  
Online Databases ◽  
Hazard Ratios ◽  
Patient Prognosis

Abstract Background MicroRNA-140 (miR-140) is one of the most widely investigated miRNAs in cell carcinogenesis and cancer development. Despite present proposals of employing miR-140 as a candidate biomarker for cancer prognosis, its effectiveness in predicting patient survival and clinicopathological outcome is still under debate. Methods A systematic search for English literature using online databases was performed with pre-established criteria. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to delineate the correlation between miR-140 levels and cancer patient prognosis. Results For this meta-analysis, we selected 12 papers for analysis, involving 1386 participants. Based on our analysis, high levels of miR-140 were strongly correlated with enhanced patient overall survival (OS) (HR = 0.728, 95% CI = 0.601-0.882, P = 0.001). In addition, we also observed that elevated miR-140 levels significantly led to better OS in patients with cancers in different parts of the body like digestive system (HR = 0.675, 95% CI = 0.538-0.848, P = 0.001), digestive tract (HR = 0.709, 95% CI = 0.565-0.889, P = 0.003), and head and neck (HR = 0.603, 95% CI = 0.456-0.797, P < 0.001). Additionally, we verified that the low miR-140 levels was related to advanced TNM stage (OR = 0.420, 95% CI = 0.299-0.590, P < 0.001), worse histologic grade (OR = 0.410, 95% CI = 0.261-0.643, P < 0.001), and positive lymph node metastasis status (OR = 0.341, 95% CI = 0.144-0.807, P = 0.014). Conclusions Taken together, our results suggest that elevated miR-140 levels can be employed as a favorable biomarker for cancer patient prognosis. This information can greatly benefit in the formation of an individualized therapeutic plan for the treatment of cancer patients.

scholarly journals Métodos para avaliação da sarcopenia em pacientes hospitalizados com câncer do trato gastrointestinal

2021 ◽  
Vol 4 (35) ◽  
pp. 371-376
Author(s):  
Fabiana Lais de Oliveira ◽  
Rafaely de Fátima Fernandes Almeida Vieira ◽  
Angelica Rocha de Freitas Melhem ◽  
Dalton Luiz Schiessel ◽  
Silvana Franco ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Gastrointestinal Tract ◽  
Cancer Patients ◽  
Handgrip Strength ◽  
The Body ◽  
The Other ◽  
Adductor Pollicis Muscle ◽  
Patients With Cancer ◽  
Alternative Assessments ◽  
High Prevalence

Introduction: Sarcopenia is characterized by the association of loss of lean mass and functionality, and in cancer patients it is a frequent situation. Thus, the study aims to assess the presence of sarcopenia in hospitalized patients with cancer of the gastrointestinal tract using alternative assessments to analyse the patient’s strength and functionality. Methods: To assess sarcopenia in cancer patients, the thickness of the adductor pollicis muscle (APM), dynamometry to assess handgrip strength and the Barthel Scale to analyse functionality were collected, associating APM and dynamometer and MAP. with Barthel scale in cancer patients. Results: Twenty patients participated in the study, with moderately malnourished patients showing greater strength in the dynamometer in relation to the well-nourished ones and that obese individuals had greater APM in relation to other nutritional states. Regarding functionality, most patients 80% were classified as independent. Patients with esophageal cancer had MAP inferior to the other locations of the body evaluated, but compared with the dynamometer they presented better results. Conclusions: There was no high prevalence of sarcopenia among patients with cancer of the gastrointestinal tract using the methods used APM, dynamometer and Barthel Scale.

Effect of a multidisciplinary cancer conference for thoracic malignancies on patient care management.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 112-112
Author(s):  
Henner M. Schmidt ◽  
John M. Roberts ◽  
Artur M. Bodnar ◽  
Steven H. Kirtland ◽  
Sonia H. Kunz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Treatment Plan ◽  
Treatment Decision ◽  
Primary Treatment ◽  
Prior Treatment ◽  
Tumor Board ◽  
Treatment Decision Making

112 Background: Treatment of thoracic cancers frequently involve multiple subspecialties thus treatment decisions are typically best facilitated in multidisciplinary tumor boards (MTB). This approach should facilitate and improve treatment decision making, standardize staging and therapeutic decisions and improve outcomes. In this study we analyze the evolution in staging and treatment decision making associated with presentation at MTB. Methods: Retrospective review of all patients with lung or esophageal cancer presented at our weekly MTB from June 1, 2010 to September 30, 2012. All providers submitting patients to tumor board recorded their current treatment plan prior to presentation. The physician’s plan was then compared to the tumor board’s final recommendation. Changes made were graded according to degree of magnitude as minor, moderate or major change. Minor changes included changes in diagnostic imaging. Moderate changes involved modifications in the type of invasive staging or biopsy procedures. Major changes were defined as changes to final therapeutic plans such as surgery, chemotherapy, or radiation therapy. Results: 435 patients with esophageal or lung cancer were discussed in the MTB. 86 patients having no prior treatment plan available were excluded. In the remaining 347 patients there were 163 patients with esophageal cancer (47%) and 184 patients with lung cancer (53%). In the esophageal cancer patients a change to the physician’s prior treatment plan was recommended in 33 cases (21%). For lung cancer patients a change in the treatment plan was recommended in 50 cases (27%). Overall a recommendation for change in treatment occurred in 83 cases (24 %). Changes were major 13%, moderate 6% and minor 5%. Follow-up in 249 patients confirmed that MTB recommendations were followed in 97% of cases. Conclusions: MTB recommendations frequently differs from the physician’s primary treatment plan. MTB reviews have previously been documented to improve patient’s outcome. The study demonstrates that in one quarter of patients MTB recommendation will be different from the primary treatment plan. Complex cancer patients should be considered for presentation at MTB whenever feasible.

Thiamine deficiency observed in a cancer patient's caregiver

2019 ◽  
Vol 17 (5) ◽  
pp. 611-613
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Takao Takahashi ◽  
Daisuke Furuya ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Thiamine Deficiency ◽  
Detailed Examination ◽  
Care Providers ◽  
Psychological Issues ◽  
The Family ◽  
Hospital Visits ◽  
One Year ◽  
Loss Of Appetite ◽  
Thiamine Level

AbstractObjectiveThiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer; however, TD has not been recognized in the family caregivers of cancer patients to date.MethodFrom a series of cancer patient caregivers, we reported an aged family caregiver who developed TD while caring for the cancer patient.ResultThe caregiver was a 90-year-old male. He had been accompanying his wife, who was diagnosed with colon cancer 4 years previously, on hospital visits as the primary caregiver, but because of psychological issues, he was recommended to visit the psycho-oncology department's “caregiver's clinic” for a consultation. Detailed examination revealed that his appetite had been only about 50% of usual from about one year before, and he had lost 12 kg in weight in one year. The diagnosis of TD was supported by his abnormally low serum thiamine level.Significance of the resultsThis report demonstrates that there is a possibility that care providers could develop TD from the burdens associated with caregiving. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of care providers to prevent complications resulting from TD.

A case of respiratory akathisia in a cancer patient: A case report

2008 ◽  
Vol 6 (1) ◽  
pp. 79-81 ◽  
Author(s):  
Yu Sunakawa ◽  
Makoto Wada ◽  
Tomomi Nishida ◽  
MEI Wada ◽  
Kazuhiro Araki ◽  
...  
Keyword(s):  
Case Report ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Antipsychotic Medication ◽  
The Body ◽  
Chest Discomfort ◽  
Antiemetic Drug ◽  
Neurological Side Effect ◽  
Antiemetic Drugs ◽  
Unusual Type

ABSTRACTObjective:It has been reported that akathisia is a neurological side effect induced by antiemetic drugs and/or antipsychotics. Akathisia can occur in any area of the body, but respiratory akathisia is an unusual type of akathisia. Cases of respiratory akathisia in cancer patients taking antiemetic drugs have not previously been reported.Methods:We report on a case of a cancer patient taking prochlorperazine as an antiemetic drug who experienced dyspnea accompanied by severe restlessness associated with respiration. By administration of biperiden, his restlessness in respiration and dyspnea promptly disappeared.Results:This finding led us to conclude that this cancer patient was experiencing respiratory akathisia.Significance of results:Respiratory akathisia is uncommon. It is important for cancer patients that dyspnea induced by disease progression be ruled out as a cause of the respiratory restlessness. It is necessary to consider the possibility of akathisia in patients that complain of vague anxiety, chest discomfort, or dyspnea following antipsychotic medication.

The rate and treatment outcome of thiamine deficiency in cancer patients diagnosed with delirium: A preliminary study.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 205-205
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Izumi Sato ◽  
Takao Takahashi
Keyword(s):  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Psychiatric Symptoms ◽  
Medical Center ◽  
Vitamin B1 ◽  
The Body ◽  
Body Retention ◽  
Vitamin B1 Deficiency ◽  
Clinical Awareness

205 Background: Vitamin B1 is essential for life, but cannot be synthesized in vivo and must be ingested from outside the body. Retention in the body is as short as 18 days, so that long-term appetite loss can easily lead to vitamin B1 deficiency, resulting in a condition known as Wernicke's encephalopathy (WE), which is characterized by disturbed consciousness, ataxia, and ocular movement disorders. Early detection and treatment with intravenous vitamin B1 usually results in recovery without sequelae, while a delay in detection can lead to severe brain damage (Korsakoff syndrome). The mortality rate is approximately 20%. Recent studies have shown that cancer patients may also experience thiamine deficiency and WE. WE is often overlooked as the typical symptoms are nonspecific, and some cases do not exhibit the disturbed consciousness characteristic of WE. Clinical awareness can be improved by confirming the actual rate and clarifying the associated symptoms, leading to more accurate WE diagnosis. Methods: We retrospectively examined the medical records for patients admitted to Saitama Medical University International Medical Center between 1 October 2014 and 31 May 2018 with cancer as the main disease who consulted the Psycho-oncology Department and were diagnosed with delirium by a psychiatrist. Patient background, medical treatment, neurological symptoms, blood biochemical findings, and disease course after vitamin B1 administration were examined. This study was approved by the IRB of this institution (Approval No. 18-080). Results: Eligibility criteria were met by 76 of 126 patients who received consultations during the study period, with 32 (43%) having a vitamin B1 deficiency. Vitamin B1 treatment led to a full recovery in 19 (59%) of these 32 patients. Conclusions: Our results show that the rate vitamin B1 deficiency in patients in this study was high, although >50% of the affected patients recovered with treatment. This indicated that it is necessary to pay close attention to vitamin B1 deficiency in cancer patients with psychiatric symptoms, and future study is planned to clarify the factors involved in the onset of vitamin B1 deficiency.

scholarly journals A Case of Wernicke Encephalopathy in a Dementia Caregiver: the Need for Nutritional Evaluation in Family Caregivers

2020 ◽  
Author(s):  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Kumi Itami ◽  
Izumi Sato ◽  
Akira Yoshioka ◽  
...  
Keyword(s):  
Thiamine Deficiency ◽  
The Body ◽  
Dementia Patient ◽  
Wernicke Encephalopathy ◽  
Case Presentation ◽  
Dementia Caregiver ◽  
Ocular Symptoms ◽  
Psychiatric Outpatient Clinic ◽  
The Family ◽  
Loss Of Appetite

Abstract Background: We report a case in which a family member caring for her mother with dementia developed Wernicke encephalopathy, which is a neuropsychiatric disorder caused by acute/subacute thiamine deficiency, during the course of care. Case presentation: A 63-year-old woman consulted our psychiatric outpatient clinic complaining of difficulty in providing care. She had started caring for her mother with dementia 6 months previously, during which time she began to feel tired. In addition, a loss of appetite had appeared 2 months prior to her visit, and this had decreased to about 30% of normal from 10 days previously. Neurologically, she experienced mild unsteadiness, but she was fully conscious and had no ocular symptoms. Based on the fact that the store of thiamine in the body is exhausted in about 18 days, the possibility of thiamine deficiency was considered, and her unsteadiness disappeared after an intravenous injection of thiamine. Test results showed her serum thiamine level to be abnormally low, and the patient was diagnosed with Wernicke encephalopathy. Conclusions: The burden of caring for a dementia patient may affect the nutritional status of the family caregiver. Thiamine deficiency should be one of the items considered as a nutritional issue in such caregivers.

Subclinical thiamine deficiency identified by preoperative evaluation in an ovarian cancer patient: Diagnosis and the need for preoperative thiamine measurement

2018 ◽  
Vol 17 (5) ◽  
pp. 609-610 ◽  
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Daisuke Shintani ◽  
Tadaaki Nishikawa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Clinical Symptoms ◽  
Preoperative Evaluation ◽  
The Body ◽  
Psychiatric Evaluation ◽  
Eye Symptoms ◽  
Her 2 ◽  
Loss Of Appetite

AbstractObjectiveAlthough thiamine deficiency (TD) and Wernicke encephalopathy (WE) are not rare in cancer patients, the cases reported to date developed TD and/or WE after treatment had started.MethodFrom a series of cancer patients, we report a patient diagnosed with TD without the typical clinical symptoms of WE at the preoperative psychiatric examination.ResultA 43-year-old woman with ovarian cancer was referred by her oncologist to the psycho-oncology outpatient clinic for preoperative psychiatric evaluation. Her tumor had been growing rapidly before the referral. Although she did not develop delirium, cerebellar signs, or eye symptoms, we suspected she might have developed TD because of her 2-month loss of appetite as the storage capacity of thiamine in the body is approximately 18 days. The diagnosis of TD was supported by abnormally low serum thiamine levels.Significance of resultsCancer therapists need to be aware that thiamine deficiency may occur even before the start of cancer treatment. In cases with a loss of appetite of more than 2 weeks’ duration, in particular, thiamine deficiency should be considered if the tumor is rapidly increasing, regardless of the presence or absence of delirium.

Thiamine deficiency in a patient with recurrent renal cell carcinoma who developed weight loss with normal appetite and loss of energy soon after nivolumab treatment

2019 ◽  
Vol 18 (2) ◽  
pp. 241-243 ◽  
Author(s):  
Hideki Onishi ◽  
Takashi Okabe ◽  
Nozomu Uchida ◽  
Suguru Shirotake ◽  
Maki Todo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Renal Cell ◽  
Storage Period ◽  
The Body ◽  
Future Research ◽  
Effective Treatment Option ◽  
Recurrent Renal Cell Carcinoma

AbstractBackgroundNivolumab has become an effective treatment option for cancer in various sites; however, this drug may cause immune-related adverse effects due to its mechanism of action. Furthermore, little has been reported on thiamine deficiency (TD) in patients receiving nivolumab treatment.MethodFrom a series of cancer patients, we reported a patient with recurrent renal cell carcinoma who developed TD after the start of nivolumab treatment.ResultsA 74-year-old man with recurrent renal cell carcinoma was referred to the psycho-oncology department as he had lost about 4 kg and displayed a loss of energy after four cycles of nivolumab treatment. Psychiatric interviews revealed a decrease in energy. Neurological examination did not reveal any impairment in consciousness, ataxia, or ocular symptoms. He did not develop appetite loss. The malabsorption or overconsumption of some nutrients is thought to occur due to the rapid loss of weight; thus, a reduction in vitamin B1, which has a short storage period in the body and is often deficient in cancer patients, was suspected. The diagnosis of TD was supported by the patient's abnormally low serum thiamine level.Significance of resultsIn patients treated with nivolumab, it is necessary to pay careful attention to TD when proceeding with the treatment. It is hoped that future research may reveal the link between nivolumab administration and TD.

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